Methotrexate Practices for Psoriasis Vary Widely Among Dermatologists

An international survey uncovers differences in methotrexate treatment of psoriasis among dermatologists and from current recommendations.

Methotrexate has been a mainstay of psoriasis treatment for over 50 years. Because it received regulatory approval before carefully conducted clinical trials were required, evidence-based protocols for psoriasis treatment are rare. Guidelines on methotrexate treatment of psoriasis have been published (J Am Acad Dermatol 2009; 60:824 and 61:451; J Eur Acad Dermatol Venereol 2009; 23:1). These investigators surveyed dermatologists regarding methotrexate therapy for psoriasis in clinical practice; 481 dermatologists from 63 countries, including 10 from the U.S., responded.

The most common starting dose was 7.5 mg per week; more than two thirds recommended an initial dose of 10 mg or less. Although the mean maximum recommended dose was 22.1 ± 5.…

Reviewing Author

Craig A. Elmets, MD

Disclosures

Consultant / Advisory board Astellas Pharmaceuticals

EquityVaxin

Grant / Research support NIH; NIH/NCI; Veteran’s Administration; Ferndale Laboratories; Kyowa Hakko Kirin Pharma, Inc.

Editorial boards Cancer Prevention Research; Photodermatology, Photoimmunology, & Photomedicine; UpToDate; eMedicine; Journal of Dermatological Sciences; JAMA Dermatology

Leadership positions in professional societies American Academy of Dermatology (Vice Chair, Committee on Science and Research); Photomedicine Society (Board of Directors)